NPIMap

Organization Active NPI

Camelot Community Care, Inc.

  • Case Management Agency
  • Clearwater, FL
National Provider Identifier
1629745575
Registry record updated Aug 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
CAMELOT COMMUNITY CARE, INC.
Practice address
4910 Creekside Dr Ste D
Clearwater, FL 33760-4034
Phone
(727) 593-0003
NPI assigned
Aug 27, 2021
Last updated
Aug 27, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jana Allen
Title
Director of Ar
Phone
(727) 593-0003

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X NU Primary
Community/Behavioral Health Agency 251S00000X NU

Addresses

Primary practice location

4910 Creekside Dr Ste D
Clearwater, FL 33760-4034

Mailing address

4910 Creekside Dr Ste D
Clearwater, FL 33760-4034

Other identifiers 1

IdentifierTypeStateIssuer
910585900MedicaidFL

National Provider Directory

National Provider Directory
Tax ID family
Camelot Community Care Inc21 organizations share this tax ID, including this one

Other organizations with this tax ID 20

Organizations that report the same tax identification number in the National Provider Directory.

View all 20

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1630022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630022400000",
    "number": "1629745575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4910 CREEKSIDE DR STE D",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337604034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4910 CREEKSIDE DR STE D",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337604034",
            "telephone_number": "727-593-0003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMELOT COMMUNITY CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-27",
        "last_updated": "2021-08-27",
        "certification_date": "2021-08-11",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "JANA",
        "authorized_official_title_or_position": "DIRECTOR OF AR",
        "authorized_official_telephone_number": "727-593-0003"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "910585900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.